A recently approved physical therapy treatment has made its arrival in Mitchell, as South Dakota catches up to a fast-growing trend of dry needling.

At Dakota Physical Therapy in Mitchell, Matt Bosma is among the first physical therapists in the state to be approved to conduct dry needling treatments for muscle pain. Dry needling is a technique that includes using a thin needle to penetrate the skin and to stimulate underlying muscles. He said it makes sense for the physical therapy businesses because they deal with muscular and skeletal pain every day.

"It's a relatively new intervention strategy in South Dakota, even though it's been around for a number of years (elsewhere)," Bosma said. "Based on the updated research we've seen, there's a lot of good outcomes out there, and it was something I wanted to get further educated on and bring it to a rural area, where there's definitely a need for it."

Muscles sometimes develop knotted areas called trigger points, which can be painful when touched and cause pain over a large area. Clinicians push small needles through the skin, which can help release tightness in the muscles and can increase functionality.

As of 2017, South Dakota was one of six states where dry needling was specifically prohibited, while other states have ambiguous rules about dry needling. Legislation passed March 1, 2018, and later signed into law, allowed South Dakota physical therapists to perform dry needling. In order for a physical therapist to practice the act, he or she would need to complete a course study of dry needling as approved by the South Dakota Board of Medical and Osteopathic Examiners.

Dakota Physical Therapy Co-Owner Josh Moody said dry needling is "another tool in the toolbox" for treating pain, whether that's chronic pain, muscle tightness or spasms. Moody said he was one of the first people at the business to be a test case for Bosma.

"It was incredibly painless, much smaller than a prick and a blood draw," said Moody, before cracking a joke. "For me, the fear factor was quite low."

Bosma, an Armour native who has worked at DPT for almost three years, said he was familiar with dry needling because some of the techniques were taught during his doctoral physical therapy studies at the University of South Dakota. In November, he completed an intensive three-day course with lectures and labs on dry needling and its relationship with movement.

Bosma said he's received good feedback from patients, primarily for neck and lower back pain, noting it's a less-invasive form of intervention for pain. He said there can be some applicability for referred pain patterns, too, which is the pain perceived at a location other than the stimulus point.

Bosma and Moody said they commonly get questions about how dry needling compares to acupuncture and both have similar materials and similar needles but the application is different.

"With dry needling, it's typically going to following muscular and skeletal impairments, trigger points within the muscle, referred pain patterns," he said.

Moody said another advantage of dry needling is that electrical stimulation can also be used to help restore the muscles. Because the levels of stimulation can be adjusted, he said it provides a case of objective evaluation that sets it apart from acupuncture.

"You can definitely get a little more definitive and exact with your treatment strategy," Bosma said.

Acupuncture and dry needling advocates have gone back and forth about each other's form of treatment, with dry needling proponents saying that specific dry needling skills are supplementing their physical therapy training. Acupuncturists claim dry needling is merely an extension of its centuries-old treatment under a different name.

Bosma said dry needling is generally part of a larger treatment plan, with his patients generally getting treatment one to two times a week and the duration is based on patient response, generally capped at two or three weeks before reevaluating.

"It's really exciting to be on that first line of people, in the state, getting certified and bringing it to a rural area where we obviously see a wide variety of patients and applying it to a group of people who can really see a benefit," he said.

Moody said treatments like dry needling could become increasingly important in the future, especially since he said it's important to help patients overcome pain levels without having to be on excessive amounts of medicine.

"It's another intervention that we can offer that's non-medicinal," Moody said. "When you think about what we have going on with opiods in this country ... physical therapists will be at the forefront of trying to help overcome and help these people. This is non-medicinal, non-addictive and it's part of a responsibility for us."